Healthcare Provider Details

I. General information

NPI: 1679210025
Provider Name (Legal Business Name): JOHANNE JOSEPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2022
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5904 ORCHARD WAY
WEST PALM BEACH FL
33417-5616
US

IV. Provider business mailing address

5904 ORCHARD WAY
WEST PALM BEACH FL
33417-5616
US

V. Phone/Fax

Practice location:
  • Phone: 561-373-6566
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11016272
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11016272
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: